Injury Prevention and Recovery

Unfortunately, injuries amongst runners are quite common. I believe that good Running Form, especially Cadence, and good running shoes can help prevent many injuries.

1 General recommendations

• Knowing how to cope with an injury is a key to recovery. (Hint: denial is not an effective coping strategy!)
• Should you race while you have an injury? The answer of course is "it depends", but it's useful to know how to weigh up the pros and cons, and evaluate your specific injury. I have some more specific advice for running with a cold or other illness, as well as a look at what science tells us about how running affects your immune system.

2 Preventing and Fixing injuries

• Many runners take NSAIDs such as Ibuprofen, but these drugs impair healing and can interfere with hydration. (Acetaminophen/Paracetamol is also covered here, even though it's not really an NSAID.)
• I have consistently found that Cryotherapy (Icing) can provide amazing levels of recovery from muscular damage. (Should only ever use ice cubes in a bag, never gel packs. Gel packs are evil; they start off cold enough to cause skin damage, then warm up too quickly to be of any value.)
• I use Massage to prevent injury, as well as to repair minor problems before they become a serious injury. It's important to know where to apply massage, and frequently the source of a tendon or joint pain is actually in a muscle that is not causing any pain. This approach is known as Trigger Point Therapy.
• While it is a common belief that runners should stretch, the scientific evidence refutes this unless you have a muscle that is so tight it is limiting your range of motion.
• The idea of exercising your muscles without conscious effort sounds too good to be true, and that is the promise of Electrical Muscle Stimulation (EMS). While EMS is not a substitute for exercise, it can provide a useful form of extra training, and perhaps more importantly it can be used to rehabilitate injuries. With EMS it's possible to stimulate a small part of a muscle, something that's not possible with normal exercise.
• Many people take Joint Supplements (glucosamine and chondroitin), but they provide marginal benefit. If you can afford them, they are quite safe so that limited benefit may be worthwhile to you.

3 Specific Injuries

• One of the most common problems that people have while exercising is Delayed Onset Muscle Soreness (DOMS), where the muscles become sore a day or so after the exercise. This is a specific type of muscle damage, and can't be serious enough to be disabling.
• One of the most devastating injuries for a runner is Overtraining Syndrome, which can last for months and in many cases years. The term is a little misleading, and I believe it should really be called "Training Induced Clinical Depression". There are other forms of Overtraining that are more minor, and probably the best way of avoiding this type of problem (and of structuring your training) is to understand and reduce Training Monotony.
• A common problem for runners is Knee Pain (Runner's Knee). This article looks at the scientific evidence behind the causes and possible treatments for runner's knee.
• Shin Splints can be an extremely dangerous but rare condition known as "compartment syndrome", but is typically just excessive stress.
• Another type of pain around the knee is Iliotibial band syndrome (AKA ITB Syndrome or ITBS). This is sometimes confused with Knee Pain (Runner's Knee).
• Pain along the underside of the foot, where the connective tissue joins the heel to the ball of the foot is called Plantar Fasciitis. This pain is typically worse first thing in the morning.
• There is no clear answer to what causes Cramps, but there are a couple of leading series and some potential solutions.
• If you're an Ultrarunner then you're likely to encounter Sore Feet at some point.
• Mortons Neuroma is a burning pain in the forefoot, usually between the bones connected to the third and fourth toes (metatarsal heads).
• Digestive problems plague many runners, especially Ultrarunners that half to eat during crisis. These digestive issues can affect what I euphemistically call "Lower GI Problems" as well as the upper digestive system (stomach). I've had particular problems with Nausea, which is a rather more complex phenomenon than you might expect.
• I had Back Surgery in 2004, and I documented my experience in case it is of use to others.

4 Blisters

I suffer from a serious genetic skin disease called Epidermolysis Bullosa (literally "skin of the blisters"), and I can run ultramarathons without suffering blisters.

• Blister Prevention provides a detailed analysis of what causes blisters, and how to prevent them. I include details of blister prevention for each area of the foot.
• If at all possible you should avoid Popping Blisters, but there are circumstances where it's necessary to prevent further problems.
• socks are a key aspect of preventing blisters, so here I give you details of what to look for in your socks, as well as reviewing a number of different types of sock.
• I highly recommend you cutting open the toe box of your shoes. While this sounds interesting, it greatly improves the comfort and reduces the chance of blisters. Next time you were born out a pair of running shoes, give this a try to see how it suits you. I have also used rather more Extreme Shoe Modifications to allow me to run with a blister.
• You may have to Tape your feet to prevent or treat blisters, so this should be a last resort.
• It is possible to toughen up the skin on your feet.